Mid‐point transverse process to pleura block: clarity or confusion? A reply
Bibliographic record
Abstract
We thank Drs Narayanan and Venkataraju for their comments on our editorial 1. In no way have we attempted to standardise the nomenclature of newer posterior truncal blocks in the paraspinal area. This would require a much wider discussion and consensus than presented in our editorial. We have merely questioned what truly defines a paravertebral block and introduced the reader to the concept that both these newer blocks and traditional landmark paravertebral blocks may achieve paravertebral block via indirect spread, or by proxy 1. We commend the authors on their detailed knowledge of anatomy of the superior costotransverse ligament (SCTL). As they quite correctly state, our schematic diagram is intended to help visualise the concepts discussed in the editorial, rather than to be an accurate anatomical illustration. We disagree that this will confuse the reader, and hope that our description of the mid-point transverse process to pleura (MTP) block 2 reinforces the needle end-point and technique of insertion. In or original description, we defined the mid-point between the transverse process and the pleura as our end-point – the SCTL does not need to be visualised during block insertion, which is one of the benefits of the MTP block. In our experience, injection lateral to the transverse process and posterior to the internal intercostal membrane produces a block with similar effect to the MTP and generates pleural displacement. Our schematic merely highlighted the various needle end-points to the true paravertebral space, rather than acting as a roadmap for needle insertion, and we apologise if that was not clear.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".